Mini-Dose Long Gonadotropin-Releasing Hormone (GnRH) Agonist Versus Agonist Flare Stimulation Protocol for in Vitro Fertilization Poor Responders
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- Category: Vol. 81, September 2013
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Mini-Dose Long Gonadotropin-Releasing Hormone (GnRH) Agonist Versus Agonist Flare Stimulation Protocol for in Vitro Fertilization Poor Responders, MONA M. SHABAN and ALY H. MOWAFY
Abstract
Aim of the Work: To compare 2 stimulation protocols, mini-dose long gonadotropin releasing hormone (GnRH) agonist versus agonist flare for in vitro fertilization poor responders.
Design: Prospective comparative nonrandomized clinical trial.
Setting: Kasr Al Ainy IVF center, Cairo University Teach-ing Hospital from February 2013 to July 2013 on 50 women undergoing IVF/ICSI fulfilling the criteria of poor responders.
Material and Methods: Patients were allocated into 2 groups, group 1 (n=25) received mini-dose long agonist and group 2 (n=25) received agonist flare protocol.
Main Outcome: Number of oocytes retrieved (primary outcome), duration of stimulation (days), peak E2 level on the day of hCG injection, number of fertilized oocytes, number of transferred embryos and pregnancy rate/cycle.
Results: Both groups were comparable regarding age, body mass index and duration of infertility (years). The difference in basal FSH, duration of stimulation (days) doesn't reach statistical significance (p-value 0.833 and 0.373 respec-tively). There was high statistical difference between both groups regarding peak E2 on day of hCG injection, number of oocytes retrieved, number of fertilized oocytes, number of transferred embryos; which is higher in mini-dose agonist group (p-value 0.000).
Pregnancy rate/cycle was higher in mini-dose agonist group (9/25 vs. 6/25) however this difference doesn't reach statistical significance (p-value 0.355) which may be attributed to small sample size or advanced maternal age.
Conclusion: Mini-dose long GnRHa stimulation protocol appears to be more beneficial for poor responders than GnRHa agonist flare.